Reemergence of Electroconvulsive Therapy

      ECT, as you may know, stands for Electroconvulsive Therapy which is a psychiatric treatment in which an electric current is passed through the brain inducing a seizure. Usually, ECT is used in cases of severe depression and other forms of severe mental illness that have not been responsive to any other forms of treatment. This therapy is good for such cases as the improvement is usually drastic and immediate and is also very effective in treating previously unresponsive illnesses. Unlike many other psychiatric treatments most people have at one point in their lives have heard of Electroconvulsive Therapy. However, they seem to almost always have an immediate negative response to it because of its persistent stereotype as a cruel and barbaric treatment. Though their negative responses are not completely unwarranted as ECT is still a hotly debated issue with strong arguments both for and against the treatment. There is definitely many more studies and trials to be done before a consensus is reached on this treatment.

History of Electroshock Therapy:

The idea of the improvement of mental function due to convulsions was definitely not a new idea at the time of the first ECT treatment. Many years before the first electric current was administered to a psychiatric patient, scientists had hypothesized that convulsions could lighten the effects of a severe mental illness. It was noted many times that mental patients seemed to get better when suffering from an illness that would cause convulsion and/or severe symptoms. This lead to Ugo Cerletti in 1937 to of conceive the idea of using electricity to create convulsions in the brain. In the first test the improvement of the patients was startling and the practice took off. This practice was effective, but began to be abused in mental hospitals as patients were given this treatment many times a day and without the proper procedures or restraints. This caused many severe and negative symptoms in patients and that would lead doctors to prescribe more ECT repeating the cycle. As awareness of the horrible conditions of asylums grew so did the public’s distaste of ECT and it began to fall out of favor.

ECT Today:

Electroconvulsive Therapy has made a comeback in the last ten or so years and was deemed civil by both the American Psychiatric Association and the Surgeon General. It is easy to see why electroconvulsive therapy is so appealing to doctors as its effects are immediate and drastic; which is exciting due to the fact that in most mental patients using other treatments it can take weeks or even months for them to show signs of improvement. A leading argument for ECT is that most of the adverse effects of ECT were caused by the mishandling of patients and inadequately executed procedures. They state that with the proper procedures, ECT is a safe and effective procedure that can raise a patient’s standard of living greatly. Advocates against ECT argue that its negative side effects such as cognitive problems and short-term memory loss are too severe to justify ECT as a treatment. They also state that this treatment is not a permanent solution and that if stopped mental problems will most likely return. Doctors are afraid that ECT will be used on its own and not as a tool to help treat the underlying cause of the patient’s mental illness.

Today ECT is administered in many mental health clinics across America, Europe and other countries. In most countries doctors are legally obliged to ask a patient for consent before they administer the procedure. It is only in severe cased of mental illness in which a patient id in dire need or treatment, but is unable to consent is the doctor permitted to perform the procedure without patient approval.  Since the patient should not eat anything a few hours before the therapy, inpatient hospitals usually ECT is done in the early morning before breakfast. The patient is first given anesthesia and muscle relaxant so no injuries result due to body convulsions during the treatment. Then while under anesthesia an electric shock is administered to the patient. The electric shock can range from 250 volts to 450 volts and be administered for 30 to 60 seconds depending on the procedure. After the treatment patients are usually in a confused state with temporary short-term memory problems that most often will dissipate after a short period. ECT is normally given three times a week for the first month and afterwards treatments become more spread out. In some cases treatments can be stopped with out relapse, but in other cases a patient’s mental health will worsen soon after the treatments stop. Some studies have shown that ECT can lead to permanent cognitive problems, but there are an equal amount of studies that disprove that notion, so a definitive conclusion has not been reached.

The use of ECT is still very controversial and we will need many more years of trials and debates before we fully understand the pros and cons of this procedure. In the end, the choice of receiving this procedure is and will only ever be the patient’s and should never be forced upon them or completely excluded from their treatment options.

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